Presently, the replacement of an endotracheal tube placed in a patient includes disconnecting the endotracheal tube from a ventilator and inserting a sealed endotracheal obturator into the airway of the tube. The obturator is passed completely through the endotracheal tube and into the trachea of the patient. The endotracheal tube is then removed from the trachea of the patient over the obturator while the obturator remains in the trachea of the patient. Since the tissue surrounding a chronically placed endotracheal tube often becomes inflamed, an obturator is positioned in the passageway of the endotracheal tube to provide a guide for inserting the replacement tube through the inflamed tissue of the patient's airway. Furthermore, the patient's airway tissue may have become so inflamed as to completely encapsulate the obturator and essentially cut off air flow to the lungs. In many cases, the replacement endotracheal tube is simply inserted over the positioned obturator and quickly inserted into the patient's airway. As a result, ventilation of the patient is restored without any adverse affect to the patient. The obturator is withdrawn from the replacement endotracheal tube, and the replacement endotracheal tube is connected to the ventilation apparatus to resume normal ventilation of the patient.
However, during this replacement procedure, it is not uncommon to encounter problems in the insertion of the replacement endotracheal tube. The tissue of the patient's airway passage may have become so inflamed so as to make the insertion of the replacement endotracheal tube a time-consuming process even with the obturator positioned in the patient. The insertion of the replacement endotracheal tube may also cause trauma or bleeding to the airway passage tissue further complicating the replacement process. The physician can readily accommodate these complications; however, time becomes a critical factor when the inflamed tissue has entirely blocked the airway preventing normal ventilation of the patient.
Instead of a sealed obturator, physicians have been known to cut off a length of medical grade tubing with an airway therein to serve as an endotracheal tube obturator. In those instances where the physician is aware of the severely inflamed tissue condition, this tube provides limited ventilation of the patient during the replacement procedure. However, the cut-off tube does not have any fitting or connector for connection to ventilating equipment during the replacement procedure. Furthermore, the distal end of this makeshift obturator often becomes blocked with mucous as the tube extends beyond the distal end of the endotracheal tube. Such blockage is commonly unknown to the physician until the endotracheal tube is removed. As a result, the makeshift obturator does not alleviate the ventilation problem during a prolonged replacement procedure and, in fact, prolongs the procedure due to it being more flexible than most endotracheal obturators.